Between 2013 and 2016, the state of Kentucky experienced a veritable medical miracle.

In 2013, two of every five low-income people in the state had no health insurance. By 2016, only one in every 13 poor Kentuckians were going uninsured.

As a result, the share of low-income Kentuckians getting annual check-ups increased by a nearly a third. And the share reporting themselves in “excellent health” jumped by over half.

What generated this medical miracle?

Kentucky simply expanded who could qualify for Medicaid. The state funded the expansion with dollars from the Affordable Care Act, the landmark legislation more commonly known as Obamacare.

A great deal, unfortunately, has changed since 2016.

Republicans hostile to Medicaid now have a lockgrip in both Kentucky and Washington. In mid-January, these hostiles turned that lockgrip into a hammer — on Medicaid recipients.

The Trump administration has given Kentucky a regulatory waiver that will, the Center for Budget and Policy Priorities documents, “reduce the number of people with health coverage and make it harder for those covered to get care.”

Officials in Kentucky claim that Medicaid needs a “work requirement.” But that makes no sense. The vast majority of Medicaid recipients in Kentucky, 77 percent, are already working. Most of the rest are taking care of elderly relatives or disabled kids, or have disabilities of their own.

No matter! The hunt for Medicaid malingerers in Kentucky will now move ahead, along with other changes that will hit the state’s Medicaid recipients with new co-pays and premiums.

All these changes will create a mountain of required paperwork. If recipients make a mistake on this paperwork, or miss a filing deadline, they’ll lose Medicaid coverage for six months.

State officials are, in fact, counting on that confusion. They’re proudly predicting that 100,000 poor Kentuckians could lose coverage.

The rarely acknowledged answer: America’s wealthy right-wing ideologues. These exceptionally deep pockets expect the elected leaders they bankroll to full-court press the poor.

This pile-on-the-poor ideology of America’s awesomely affluent spews out from the “think tanks” and academic centers they so lavishly subsidize. The hired hands at these outfits do all the heavy lifting on moves like the Kentucky Medicaid assault. They write the talking points and the legislative language.

Then the media outlets the rich underwrite finish the job. They demonize poor people as lazy laggards ever ready to snatch away and waste hard-earned taxpayer dollars.

This demonizing has been ratcheting up ever since the Reagan era. The richer America’s rich become, the fiercer the assault on the safety net programs that bring decency to America’s most vulnerable.

Why should that be the case?

Billionaires living in a society where many millions of people have no wealth — and shaky health — have a choice. They can consider their own wealth the product of a deeply flawed society that needs fixing. Or they can consider their good fortune a well-deserved reward for their own “superiority.”

Rich folks who do feel superior see people without wealth as inferior, as lazy no-accounts who deserve no “rewards” — not even health care coverage.

And all that talk about the “dignity” of work that pols love spouting as they rip the social safety net? They don’t really mean it.

These self-professed champions of “individual responsibility” have no problem with the idleness of the super rich. This past December, they rammed through Congress tax “reforms” that increase the amount of money that the lazy, no-account progeny of billionaires can inherit. Tax-free, of course.

Conservatives, in short, are cutting taxes for billionaire heirs and throwing 100,000 poor Appalachians off their health care. Exit a miracle. Enter a tragedy.